Ligating hemostat



J n 5, 1956 E. VACHERESSE, JR 2,748,773

LIGATING HEMOSTAT Filed June 24, 1954 I 2 Sheets-Sheet 1 June 1956 E. VACHERESSE, JR 2,748,773

LIGATING HEMOSTAT Filed June 24, 1954 2 SheetsSheet 2 I N VEN TOR.

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United States Patent LIGATING HEMOSTAT Edward Vacheresse, Jr., Fairmont, W. Va.

Application June 24, 1954, Serial No. 438,905

7 Claims. (Cl. 128-32 6) This invention relates to a surgical instrument.

The invention is more particularly concerned a combined hemostat and ligator or a ligating hempstat and a primary object thereof is to provide in operative association with the finger operating end portions, as well as the opposed tissue gripping jaw portions of a hemostat, finger operable means for supporting and disposing an intermediate portion of an elongated suture in a knot tying position adjacent the tissue and beyond the hemostat jaws whereby the end portions of the suture are readily accessible for tying a knot about the tissue with the hemostat jaws in closed position on the tissue.

A further object of the invention is to proyide in operative association with a scissor-like hemostat including a pair of elongated cross arms pivotally connected inter.- mediate their ends and having blood checking tissue grip.- ping jaws on corresponding'ends thereof, of means on one of the cross arms for supporting opposite end portions of a suture, and finger controllable means supported by the cross arms for guided movement of said means lengthwise thereof and having an open-eye at one end of said means for releasably engaging said suture at a point intermediate its ends; the said finger controllable means in an inoperative position disposing the inter: mediate portion of the suture beneath the jaws and in an operative position disposing same beyond the jaws and adjacent a tissue being gripped by the jaws.

Other objects and advantages of the invention Will be.-

come apparent in the course of the following detailed drawings, wherein:

Fig. 'l is a side elevational view of the instrument with the needle omitted; i

Fig. 2 is an edge -view of the instrument shown in Fig. 1. as viewed from the bottom thereof;

Fig. 3 is a side elevational view of the complete instru: ment in its initial or inoperative position pror to use there- Fig. 4 is also a side elevational view of the instrument in an operative position and subsequent to the tying of a suture; 1

Fig. 5 is an enlarged vertical sectional view in the plane of line 55 on Fig. 1;

Fig. 6 is a vertical sectional view in the plane of line 6- 6 on Fig. 5;

Fig. 7 is an enlarged vertical sectional view in the plane of line 77 on Fig. 2;

Fig. 8 is a sectional view of a block in a plane at right angles to the section in Fig. 5; and

Fig. 9 is a broken side view of a needle embodied in the instrument.

Referring now in detail to the drawings, the improved instrument is generally of scissor-like form and comprises a pair of cross arms 10 and 11 each of which is provided with a finger loop 12. The cross arms 10 and 11 are pivotally connected at their crossing point by a pivot pin 13 and are provided with terminal jaws 14 and 15 re- 2,748,773 Patented June 5, 1956 ice spectively which have serrated tissue clamping faces 16 and 17.

. {The ,cross arms 1!) and 11 are provided with inwardly directed cooperating projections 18 and 19 respectively, the former of which is provided with ratchet-like teeth 20 and the latter of which is provided with a single tooth 21 for interengaging with the teeth 20 for holding the jaws 14 and 15 in closed operative position.

The structure so far described is generally similar to structure heretofore provided wherein the serrated jaws are adapted to grip a tissue to stop or prevent bleeding and is generally known as a hernostat.

The present invention is particularly concerned with ligating means ,operatively associated with the hemostat above described and such ligating means are readily applicable .to hemostats of other or ,existingdesigns which as above referred to are of the general form.

In accordance with the present invention, the hemostat irrespective of its general construction, embodies certain structural features adapting it to the operative support of ,the improved ligating device.

7 Accordingly, the cross arms 10 and 11 are provided with lugs 22 and 23 respectively and such lugs are each provided with an elongated aperture 24 and as is indicated in Fig. 1, the apertures 24 have their axes aligned in the closedposition of the hemostat.

' Furthermore, the cross arm 10 has disposed intermediate the lug 22 and the respective loop 12, a stop 2.5 of rectangular cross section as indicated at 26 and the cross arm 10 is further provided with transversely aligned suture positioning clips 27 which are positioned intermediate the pivot pin 13 and the jaws 14 and 15. .Otherwise, the hemostat may be of the specific form disclosedor of various other forms.

The improved ligating device in accordance with a preferred embodiment of the invention comprises an elongated flexible needle 28 which is axially movable within the apertures 24 and which at its advance end is provided with a suture receiving angularly disposed .open- .eye 29 and the opposite or rear end of the needle is re.- movably connected to a trigger member 30 which is slid- .ably supported on the rectangular portion 26 of the cross arm 19. The trigger member 30 which may be .of vvar iou s forms, preferably comprises a block 31 (Fig. ,8) disposed between the opposite sides 32 of a U-shaped strap "33 and suitably secured thereto as by screws or the like 34 indicated in Fig. l.

The inner wall of the block 31 is spaced from the bight 35 of the strap providing a space for receiving the said rectangular portion 26 of the cross arm 19. The said bight 35 of the strap is extended in the provision of a leaf spring 36 whose outer free end bears on a face .of the rectangular portion 26 and the opposite face of the rectangular portion 26 is provided with ratchet .teeth 37 with which cooperates a pawl 38 rigid with the byengagement of the pawl 38 with a forward one of the ratchet teeth 37, the pawl is disengageable from the tooth upon finger pressure on the trigger 39, whereupon the spring 36 is compressed and the pawl 38 withdrawn from the teeth 37. The trigger member 36 embodies means for releasably holding the butt end of the needle 28 and such means comprises a cylindrical member 40 which is rotatably supported in an aperture 41 provided in the block 31 and the opposite sides 32 of the strap 33 and which member is provided with a finger engaging knob 42 for manual rotation thereof.

The block 31 is provided with an aperture 43 for receiving the butt end of the needle 28 and such aperture is centrally intersected by the aperture 41 as indicated in Figs. 5 and 8. The cylindrical member 40 (Fig. 6) is provided with a channel 44, having an eccentric bottom wall and the deeper portion of the channel is semicircular in cross section for cooperating with a like section of aperture 43 for receiving the needle 28 with the eccentric bottom wall of the channel frictionally engaging the needle upon rotation of the knob 42 for releasably holding the needle in operative position.

It Will be observed from Fig. 2 that the ends of the cross arms 10 and 11 in advance of the pivot pin 13 including the jaws 14 and 15 are of arcuate form for adapting the instrument for use on the more inaccessible tissues.

It is to be further observed that the clips 27 cooperate with the opposite sides of cross arm 10 whereby the end portions of a suture S are so held that the needle engaged intermediate portion thereof is maintained taut.

In the operation of the improved instrument as described, same is initially in the position indicated in Fig. 3 wherein the trigger member and the therewith connected needle 28 are in retracted position and also wherein the needle is flexed due to the non-aligned position of the apertures 24 in the lugs 22 and 23 occasioned by the angular position of the cross arms 10 and 11.

A suture S is then positioned by slipping one end thereof under the clip 27 at one side of cross arm 10, the mid-portion thereof is placed into the open ended needle eye 29 and the suture is drawn taut from the other end and slipped under the opposite clip 27.

With the hemostat ligator thus prepared the hemostat jaws 14 and 15 are closed upon the tissue T as indicated in Fig. 4 for stopping or preventing bleeding thereof.

After having been assured of the proper position of the jaws, the operator will engage the trigger 39 with his index finger which naturally lies in proper position thereto and move the member 30 forward into engagement with lug 22, as indicated in Fig. 4, and the needle Which has assumed its normal straight position will likewise be moved forward with the intermediate portion of the suture S disposed beyond the ends of jaws 14 and 15 and adjacent the clamped tissue T. The pawl 38 will engage a forward tooth 37 and retain the member 30 in its forward position.

The operator is now free to release his hold on the hemostat, either leaving it securely clamped on the tissue or yielding it to an assistant whereby both of the operators hands are free to complete the knot about the tissue T.

When the knot is completed the hemostat is unlocked and withdrawn from the tissue and the suture is automatically disengaged from the clips 27.

Having set forth my invention in accordance with a preferred structural embodiment thereof, what I claim and desire to secure by U. S. Letters Patent is:

1. A surgical instrument including a pair of intersecting pivotally connected cross arms terminatng in gripping jaws, means on one of said cross arms for supporting a suture with the mid-portion thereof disposed clear of the jaws and inwardly of the jaw ends, a second means supported on said cross arms on opposite sides of said pivotal connection, said second means including a portion movable relative to the cross arms for positioning the mid-portion of a suture in a desired operative position beyond the ends of the jaws when the jaws are in closed gripping position.

2. A ligating hemostat comprising a pair of pivotally connected cross arms having tissue gripping jaws on corresponding ends thereof, a lug on each of said arms disposed at opposite sides of said pivotal connection, said lugs each being provided with an aperture the axes of which are aligned in the closed position of the cross arms, an elongated needle slidably supported within said apertures for axial movement therein and provided at its forward end with a suture receiving element, means on one of said cross arms for supporting opposite ends of a suture with the intermediate portion thereof receivable within said element, and a second means engaged with the rear end of the needle and movably supported on said one cross arm initially disposing said element inwardly of the ends of said jaws during the open position of said cross arms and disposing same beyond the ends of the jaws during the closed position of said cross arms placing a suture into knot tying position adjacent a tissue gripped by the jaws.

3. The structure according to claim 2, wherein said first means comprises a clip at each side of said one cross arm, said clips bearing on the adjacent walls of said one cross arm for frictional engagement with the ends of a suture.

4. The structure according to claim 2, wherein said needle is flexible permitting pivotal movement of said cross arms from the closed to the open position wherein the axes of said apertures are angularly disposed.

5. The structure according to claim 2, wherein said one cross arm includes an elongated portion which is rectangular in cross section, and said second means comprises a U-shaped strap slidably supported on said reetangular portion adjacent the bight thereof, a block disposed between the arms of the strap adjacent the ends thereof and secured thereto, an aperture in said block for receiving the rear end of the needle, needle clamp means supported by the strap and block, and cooperating tensioning and ratchet means on said rectangular portion and said block for locking said strap in advanced position with said suture receiving element disposed beyond the ends of said jaws.

6. The structure according to claim 5, wherein said needle clamp means comprises a cylindrical member rotatably supported in said block, said cylindrical member having a circumferentially disposed channel therein opening into said needle receiving aperture and said channel having an eccentric bottom wall, whereby the needle is clamped in the block upon rotation of said cylindrical member.

7. The structure according to claim 5, wherein said ratchet means comprises teeth on said rectangular portion and a pawl rigid with said block and said tensioning means comprises a leaf spring projecting from the bight of said U-shaped strap and bearing on said rectangular portion for normally holding said pawl engaged with said teeth.

File Apr. 26, 1932 Martone May 18, 1954 

